Employer
Rev Lng LLC
1004 Empson Road, Ulysses, PA 16948 · EIN 46-2198572 · Jul 1, 2024 to Jun 30, 2025
Plan year 2024
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Schedule A
Direct compensation
Coverage contracts on the filing. If the carrier did not provide Schedule A, the row is listed with that note.
| Coverage | Carrier | Broker | Lives | Direct comp |
|---|---|---|---|---|
| Stop-loss | Everest Reinsurance Company | — | — | Comp not disclosed Premium $682 |
| Stop-loss | Fair American Insurance And Reinsurance Company | — | 53 | Comp not disclosed Premium $346,198 |
Schedule C
Additional compensation
Plan-paid amounts to each named party on the filing, with the role they reported. This is not a carrier commission and is not added to Schedule A.
Visible subtotal $45,786
| Party | Type | Amount | $ / Enrolled / Year |
|---|---|---|---|
| First National Insurance Agency | Broker | $22,850 | $292.95 |
| The Benecon Group | Broker | $17,190 | $220.38 |
| Meritain Health, An Aetna Company | Admin | $5,746 | $73.67 |